How fat is America? New report gives nation an F

Despite all the talk about the nation's obesity epidemic, despite all the free weight-loss and fitness advice around, not one state in the country got thinner this year, according to an annual fat report released last week.

Florida got fatter for the third year in a row, joining 15 other states that saw a rise in adult obesity over last year.

In Florida, 26.1 percent of the population weighs in as obese, placing it among two-thirds of states where at least one in four adults is obese, according to the eighth annual F as in Fat Report by the Trust for America's Health and the Robert Wood Johnson Foundation.

Overall, Florida ranked 29th, about midway between the nation's fattest state, Mississippi, and the thinnest state, Colorado. If you add in those who are also overweight, Florida's combined score soars to 62.6 percent. That means about two out of every three adults is obese or overweight (with a BMI of 25 to 29).

The report's findings put the epidemic in context:

•Twenty years ago no state had an obesity rate above 15 percent. Now every state does.

•Today, 12 states have obesity rates over 30 percent. Four years ago only one did.

•In Florida, the obesity rate has gone up 80 percent in 15 years. In 1995 it was 14.3 percent.

•Colorado, the thinnest state with a rate of 19.8 percent, would have been ranked as the fattest state in 1995. That year the fattest state was Mississippi, which had an obesity rate of 19.4 percent.

The fact that America's weight problem has mushroomed over the last 20 years is not a problem society can afford to ignore, the report emphasized. Obesity is related to more than 13 chronic diseases, including diabetes, heart disease and hypertenstion, and is the biggest reason the nation's health-care costs keep rising.

Alongside the surge in obesity, the incidence of type 2 diabetes has doubled in 10 states over the past 15 years. In Florida, the diabetes rates are among the worst: One in 10 adults here has diabetes.

"If we don't start addressing the problem, we won't turn around health-care costs. It's that simple," said Jeff Levi, director of Trust for America's Health.

The report did have one bright spot: Although not one state got thinner, fewer states got fatter, said Dr. Jim Marks, director of the Robert Wood Johnson Foundation. In 2008, 37 states had increases in their obesity rates. In 2010, the number dropped to 28, and this year it fell to 16.

"It's a small victory that indicates some of our efforts are working," said Marks. "But it doesn't mean we can take our foot off the gas pedal."

Why are we so fat?

To understand why the nation's weight problem has mushroomed in the past 20 years, obesity researchers look to the environment.

"Our genes haven't changed that much in thousands of years, but we have seen a rapid change in the environment, and that has interacted with our genetic propensity toward obesity," said Dr. Steve Smith, an obesity expert and scientific director of the Florida Hospital Sanford Burnham Translational Research Institute, inOrlando.

Marks blames a lot of little changes in American culture that have added up, including bigger food portions, giant sodas, communities designed around cars not pedestrians, cutting out PE programs in schools and spending more time in front of TV and computer screens.

"We've taken activity — as a fun way of playing — out of the daily lives of our children, and turned them toward screens," said Marks, also a pediatrician.

Government subsidies of crops such as corn, also have contributed, he said. Corn is used to make high-fructose corn syrup, a cheap, high-calorie, non-nutritious, yet widely used ingredient in many pre-packaged foods.

"No scientist in the field will say the problem is strictly one of willpower," said Smith, adding that scientists still have a lot to learn about how body weight is regulated.

Another hurdle is that the fatter folks get, the more normal fat seems. "Fat is the new normal," said Smith. "A person's ability to self-assess how fat he is goes down when everyone around is fat," he said, adding that who we hang around with affects our body weight.

Income, education and race also play a role.

Nearly 33 percent of adults who did not finish high school were obese, according to the report, compared to 21.5 percent of those who finished college. Likewise, more than 33 percent of those who earned $15,000 or less a year were obese compared to less than 25 percent of those who earned $50,000 or more.

Blacks and Latinos had higher rates of obesity than whites. In Florida, adult obesity rates for blacks were 38.8 percent, for Latinos 28.7 percent and for whites 24.1 percent.

"We haven't done a good job of community outreach to minority communities," said Cynthia Harris, director of the Institute of Public Health and a professor at Florida A&M University, inTallahassee.

To turn the trend, Harris said, community health workers will need to make grassroots changes. "They will need to get out in their neighborhoods and show others how to shop for and prepare healthier meals."

Reversing the trend

Just as many small actions caused the nation's obesity epidemic, reversing it will also take many small moves, say experts. On that list are healthier foods in schools, more parks and sidewalks, better access to fresh foods, less sugary beverages and proper portions.

All this will take time. "Public sentiment is always behind the curve," says Smith. "The scientific evidence has to percolate down until it results in societal change."

Using smoking as an example, he said, "We knew smoking caused lung cancer decades before the rate of smoking began to decline."

Like the war on tobacco, the attack on obesity will need to come from all sides — from health-care providers, legislators, businesses, family members and friends.

"This is not a national diet that will be over in a couple months," said Marks, adding that the goal is to see the nation's weight levels return to where they were in the 1970s. "We hope we're seeing that that's starting to happen, but it hasn't happened in any state yet."